Where Do People With Primary Malignant Brain Tumours Die? A National Cohort Study in England, Using GlioCova Data

Abstract

Abstract AIMS The Gliocova dataset uses linked English national cancer data on all 51,775 adult primary brain tumour patients diagnosed between 2013-2018. Despite poor outcomes, there is little work on end of life care in primary brain tumour patients. The majority of patients with cancer prefer to die at home, but most do not. METHOD We identified all patients with a malignant primary brain tumour diagnosed in England between 2013-2018 and who died up until 1st of August 2020. RESULTS 20,684 patients were selected. The median age at diagnosis was 68 years (IQR=19), 42% were female. 55% died within 6 months of diagnosis. 36% of people died at home (compared to 24% of the entire population in England), 25% died in hospital, 15% died in a hospice, 9% died in a nursing home. 15% had an unrecorded or other place of death. 47% (n=9,682) patients had radiotherapy, of which 8.7% (n=1,806) had radiotherapy in the 3 months before death; 29% (n=5,947) patients received chemotherapy (6%(n=1,292) during the last 3 months). 87%(n=18,013) patients had surgery (36%(n=7,370) during the last three months). For all treatments the chance of patients dying at home decreases if the patient has treatment in the last three months of life. CONCLUSION To our knowledge, this is the first work exploring the relationship between anti-cancer treatment near the end of life and the location of death. Further work will focus on building a comprehensive model to predict rates of death in hospital, and examine variation on a national level.